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Peyronie's disease (PD) is a relatively unknown cause of sexual dysfunction. Symptoms may include the appearance of an erectile deformity, pain in the penis and erectile dysfunction (ED). The etiology is most often unclear, and medical treatments are limited, although improvement is always possible. However, surgical treatment remains the only option when the disease has stabilized and in the event of significant erectile and sexual disability., Competing Interests: Le Dr Antoine Faix a déclaré des contrats de collaboration scientifique avec les laboratoires pharmaceutiques Sobi, la compagnie Coloplast et la compagnie Boston Scientific. Les autres auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Introduction: Lapeyronie's disease is a common condition affecting 3.4 to 9% of the male population. Knowledge of pathophysiology, natural history, and treatment outcomes can guide the care of patients., Materials and Methods: A literature review was carried out between 1940 and 2012 in Pubmed using the keywords: Lapeyronie's disease, Peyronie's disease (PD), pathophysiology of PD, surgical treatment for PD, medical treatment for PD., Results: Seventy-five articles were selected, including original articles, reviews, and recommendations in English or French. Few studies available are of level 1 and most of them are of 2b and 3 level of evidence., Conclusion: The pathophysiology of Lapeyronie's disease is controversial. Medical treatments are ineffective. Surgery should be proposed when the curvature is stabilized, and the treatment of the concavity or convexity depends on the size of the erect penis, its curvature angle and erectile function. Penile implant must be proposed to patients when erectile dysfunction is combined with severe curvature., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Peyronie's disease (PD) is due to a fibrotic plaque forms in the tunica albuginea layer of the penis. It is responsible of penile pain, angulation, and erectile dysfunction. Even though the aetiology remains unknown, the knowledge of the pathophysiology has evolved in recent years. Recent studies indicate that PD has prevalence of 3 to 9% in adult men. During the initial acute phase (6 to 18 months), the condition may progress, stabilize or regress in 20%. Therefore, a conservative treatment approach has been advocated. An initial discussion about evaluation, information, and reassurance is necessary in most cases. The most commonly employed oral therapies include tocopherol (vitamin E), and para-aminobenzoate (Potaba), which have failed to demonstrate efficiency. Intralesional injection therapies with interferon alpha-2B, verapamil are frequently used as a first-line treatment modality, and can provide an improvement in decreasing penile pain and penile curvature. Current literature has shown that extracorporeal shock wave lithotripsy was only active on the pain. Regarding penile curvature, there are discrepancies in the published series. The surgical approach is restricted to men unresponsive to nonoperative therapies (i.e., 10% of patients). In such cases, plication, grafting or even penile prosthesis implantation are conceivable management options., ((c) 2009 Elsevier Masson SAS. All rights reserved.)

Lapeyronie's disease occurs mostly in middle age men and consists in pain and bending or arching of the penis during erection. This could negatively impact quality of life. A good knowledge of the physiopathology is necessary to adapt the different treatment modalities.

The origin of Peyronie's disease remains obscure although the first description dates back to 1743. The prevalence of the disease is 388.6 per 100,000 population. Little physiopathologic data is available. Repeated microtrauma to the tunica albuginea appears to favor the onset of inflammatory phenomena, in turn the source of fibrosis. Clinical examination remains the ideal method for diagnosis and follow-up: it can be completed by ultrasonography of the corpora cavernosa. Magnetic resonance imaging does not appear to provide any significant benefits. The inflammation and pain encountered in early stages of the disease can be managed medically. Numerous treatments have been tested (oral route or local injections); results are in the course of evaluation. In the absence of well-controlled clinical trials, there is no standard medical therapy. Radiotherapy today appears inadvisable. The sequels of Peyronie's disease can be treated surgically, especially in patients who can maintain and adequate erection but suffer from a deformation incompatible with sexual activity. Numerous technical artifices have been proposed; correction of deformations is generally satisfactory but perfections need to be made concerning the quality of erection. Patients with advanced disease and severe erectile insufficiency can be offered reconstructive surgery using penile implants: results of the various procedures are analyzed.

A study of fourteen cases of Peyronie's disease with an evaluation of the hemodynamics of the erectile function shows that erectile dysfunction, as a complication, is mainly due to abnormal venous drainage from the corpora cavernosa. This article discusses the therapeutical conclusions to be drawn, in the light of the results of seven operations.

Due to the poor results obtained in the treatment of Peyronie's disease by ionophoresis and ultrasound, using the classical buffer solution of the cortisone thiomucase type, the authors have experimented ionophoresis with a new product: orgoteine a dismutase superoxide. Austrian authors have already demonstrated the value of this product. Its mechanism of action is still uncertain but it has an experimentally well demonstrated antiinflammatory activity. The good results are obvious not only on the pain, but also on the induration and incurvation, permitting the resumption of sexual intercourse in more than 75% of cases.